Clinical and economic impact of school‐based nonavalent human papillomavirus vaccine on women in Singapore: a transmission dynamic mathematical model analysis

Tay, Sun Kuie; Hsu, Tun-Ying; Pavelyev, A.; Walia, Anuj; Kulkarni, Amit

doi:10.1111/1471-0528.15106

Cited by 17 publications

(14 citation statements)

References 23 publications

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“…Our results about the general health benefits of introduction the nonavalent vaccine are in line with similar studies for other high-income countries [21, 22, 24, 58–61]. In contrast, we found that the nonavalent HPV vaccine averts a much higher number of episodes of CIN-2 and CIN-3 than two other modelling studies from Switzerland and Austria [24, 62].…”

Section: Discussionsupporting

confidence: 91%

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Impact and cost-effectiveness of nonavalent human papillomavirus vaccination in Switzerland: insights from a dynamic transmission model

Riesen

Bogaards

Low

et al. 2019

Preprint

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AIM: In Switzerland, human papillomavirus (HPV) vaccination has been implemented using a quadrivalent vaccine that covers HPV types 16 and 18, responsible for about 70% of cervical cancer. The average national uptake was 56% in girls by the age of 16 years in 2014-2016. A nonavalent vaccine, covering five additional oncogenic HPV types was recommended at the end of 2018. The primary aim of this study was to assess the impact and cost-effectiveness of introducing the nonavalent HPV vaccine in Switzerland compared with the quadrivalent vaccine. METHODS: We developed a dynamic transmission model that describes the spread of 10 high risk HPV types. We informed the model with Swiss data about sexual behaviour and cervical cancer screening, and calibrated the model to cervical cancer incidence in Switzerland. We modelled the impact of quadrivalent and nonavalent vaccines at the achieved (56%) and national recommended uptake (80%) in girls. We calculated the incremental cost-effectiveness ratio (ICER) between the nonavalent vaccine, the quadrivalent vaccine and no vaccination. We evaluated costs linked to cervical cancer screening, treatment of different disease stages and vaccination in a sensitivity analysis. RESULTS: Compared with quadrivalent HPV vaccination in Switzerland at 56% uptake, vaccinating with the nonavalent vaccine would avert 1,175 cervical cancer deaths, 3,641 cases of cervical cancer and 106,898 CIN treatments over 100 years at 56% uptake. Compared with the quadrivalent vaccine, which would prevent an estimated 67% and 72% of cervical cancer cases at 56% and 80% coverage, the nonavalent vaccine would prevent 83% and 89% of all cervical cancers at the same coverage rates. The sensitivity analysis shows that introducing the nonavalent vaccination should improve health outcomes and offers a cost-saving alternative to the quadrivalent vaccine under the current price difference. CONCLUSIONS: All scenarios with quadrivalent and nonavalent vaccination are likely to be cost-effective compared with no vaccination. Switching to the nonavalent vaccine at current and improved vaccination uptake is likely to be cost-saving under the investigated price difference.

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Section: Discussionsupporting

confidence: 91%

“…We modelled 10 different HR HPV types (16,18,31,33,35,39,45,51,52,58) and considered all other HR types as one additional type. All types were modelled separately and were then grouped in a second step to assess the overall burden of HR HPV infections.…”

Section: Hpv Transmission Modelmentioning

confidence: 99%

Impact and cost-effectiveness of nonavalent human papillomavirus vaccination in Switzerland: insights from a dynamic transmission model

Riesen

Bogaards

Low

et al. 2019

Preprint

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“…Many studies have detected both LR- and HR-HPVs in cervical samples from pregnant females. In this study, it is plausible that the two VI females found to be HPV45-positive were administered the pre-pubertal quadrivalent vaccine, which is active against HPV6/11/16/18 [ 91 , 92 ], although data on cross-protection against non-vaccine HPV types have been reported [ 93 , 94 ]. It is important to point out, however, that the vaccination status of the two VI females found to be HPV45-positive is unknown.…”

Section: Discussionmentioning

confidence: 99%

Investigation on Spontaneous Abortion and Human Papillomavirus Infection

et al. 2020

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Viral infections are considered to be risk factors for spontaneous abortion (SA). Conflicting results have been reported on the association between Human Papillomavirus (HPV) and SA. HPV DNA was investigated in matched chorionic villi tissues and peripheral blood mononuclear cells (PBMCs) from women who experienced SA (n = 80, cases) and women who underwent a voluntary interruption of pregnancy (VI; n = 80, controls) by qualitative PCR and quantitative droplet digital PCR (ddPCR). Viral genotyping was performed using real-time PCR in HPV-positive samples. Specific IgG antibodies against HPV16 were investigated in sera from SA (n = 80) and VI (n = 80) females using indirect ELISA assays. None of the DNA samples from SA subjects was HPV-positive (0/80), whilst HPV DNA was detected in 2.5% of VI women (p > 0.05), with a mean viral DNA load of 7.12 copy/cell. VI samples (n = 2) were found to be positive for the HPV45 genotype. The ddPCR assay revealed a higher number of HPV-positive samples. HPV DNA was detected in 3.7% and 5% of SA and VI chorionic tissues, respectively, with mean viral DNA loads of 0.13 copy/cell in SA and 1.79 copy/cell in VI (p >0.05) samples. All DNA samples from the PBMCs of SA and VI females tested HPV-negative by both PCR and ddPCR. The overall prevalence of serum anti-HPV16 IgG antibodies was 37.5% in SA and 30% in VI (p > 0.05) women. For the first time, HPV DNA was detected and quantitatively analyzed using ddPCR in chorionic villi tissues and PBMCs from SA and VI women. Circulating IgG antibodies against HPV16 were detected in sera from SA and VI females. Our results suggest that HPV infection in chorionic villi may be a rare event. Accordingly, it is likely that HPV has no significant role in SA.

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“…Interestingly, we observed that chorionic villi from two cases, belonging to VI group, were HPV45-positive. It is plausible that these females were administered with the pre-pubertal quadrivalent vaccine, which is active against the oncogenic HR-HPVs, -6/-11/-16/-18 [34]. Our results seem to indicate that this vaccine is unable to prevent infections from other oncogenic HPVs, such as HPV-45.…”

Section: Discussionmentioning

confidence: 71%

“…Our results seem to indicate that this vaccine is unable to prevent infections from other oncogenic HPVs, such as HPV-45. However, the potential benefit of the new large-spectrum nonavalent vaccine, which is active against HPV -6/-11/-16/-18/-31/-33/-45/-52/-58, is advocated [34].…”

Section: Discussionmentioning

confidence: 99%

DNA Sequences of Small DNA Tumor Viruses, Merkel Cell Polyomavirus and Human Papillomavirus, in Spontaneous Abortion Specimens

Tagliapietra¹,

Rotondo²,

Bononi³

et al. 2018

Preprint

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Background. The role of viruses in spontaneous abortion (SA) in not completely known. Methods. Merkel cell polyomavirus (MCPyV) and Human papillomavirus (HPV), two small DNA tumor viruses, were investigated in SA. MCPyV/HPV DNAs were investigated by PCR and droplet-digital/quantitative PCRs (ddPCR/qPCR) in chorionic villi and peripheral blood mononuclear cells (PBMCs) from SA females (n=100), the cases, and voluntary interruption (VI, n=100) of pregnancy females, the controls. Results. MCPyV DNAs were detected in 4% and 5% of SA and VI chorionic villi, respectively, with a mean DNA load of 1.99 copy/104 cells in SA and 3.02 copy/10,000 cells in VI (p>0.05). HPV DNAs were detected in 2% of VI chorionic villi, with a mean DNA load of 7.12 copy/cell. Two cases in the VI samples were HPV-45 positive. In PBMCs, MCPyV DNA was detected in 9% and 14% of SA and VI samples, with a mean viral DNA load of 2.09 and 4.70 copy/10,000 cells in SA and VI samples, respectively (p>0.05). None of PBMCs samples tested HPV-positive. Conclusions. MCPyV and HPV DNAs were quantified, for the first time, by ddPCR/qPCR in SA and VI chorionic villi and PBMCs. Data of the present study may help to better understand the role of MCPyV/HPV in SA.

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Clinical and economic impact of school‐based nonavalent human papillomavirus vaccine on women in Singapore: a transmission dynamic mathematical model analysis

Abstract: Nonavalent HPV vaccination of 11- to 12-year-old girls is cost-effective in Singapore.

Cited by 17 publications

References 23 publications

Impact and cost-effectiveness of nonavalent human papillomavirus vaccination in Switzerland: insights from a dynamic transmission model

Impact and cost-effectiveness of nonavalent human papillomavirus vaccination in Switzerland: insights from a dynamic transmission model

Investigation on Spontaneous Abortion and Human Papillomavirus Infection

DNA Sequences of Small DNA Tumor Viruses, Merkel Cell Polyomavirus and Human Papillomavirus, in Spontaneous Abortion Specimens

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